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Continuous Subcutaneous Insulin Infusion
A Comprehensive Review of Insulin Pump Therapy
M. James Lenhard, MD;
Grafton D. Reeves, MD
Arch Intern Med. 2001;161:2293-2300.
A tremendous amount of data suggest that near-normal glycemic control
prevents or delays complications of diabetes, which has led to a dramatic
increase in continuous subcutaneous insulin infusion (CSII) or insulin pump
use. In this article, the data supporting CSII in type 1 diabetes is reviewed,
and the advantages and disadvantages of CSII are analyzed. In addition, CSII
use in specific situations is examined, including during childhood and pregnancy
and while exercising. The published articles suggest that CSII provides better
glycemic control than does conventional therapy and comparable to or slightly
better control than multiple daily injections. The use of CSII may be especially
indicated during pregnancy or for preconception care and for diabetes presenting
in childhood or adolescence.
From the Diabetes and Metabolic Diseases Center, Section of Endocrinology,
Christiana Care Health Services (Dr Lenhard), and the Division of Pediatric
Endocrinology, DuPont Hospital for Children (Dr Reeves), Wilmington, Del;
and Jefferson Medical College, Thomas Jefferson University, Philadelphia,
Pa (Drs Lenhard and Reeves).
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